Friday, September 4, 2009

Health justice

Today I diverge from the subject of religions, but not spirituality. I am inspired by the life of Ted Kennedy as a story of redemption, specifically his collaboration with persons who disagreed with him and his personal journey of righting his wrongs by helping the poor and disadvantaged. He wrote in his letter to the pope, “I know that I have been an imperfect human being, but with the help of my faith I have tried to right my path."

He said giving everyone in the country access to health care was the political cause of his life. Right now that also is my cause and I’m delighted that 40 plus people demonstrated in St. Cloud to say we need more, not less, government involvement in health care.

Competing for profits works fine for selling stuff, but it doesn’t take care of sick people. We can shop for refrigerators and cars, but nobody shops for health care because we don’t know “the product.” In times of need, doctors don't shop for health care, they rely on the expertise of other trusted doctors.

Our profit-driven system results in 60% of surgeries being unjustified. Among the most frequently performed unnecessary surgeries are hysterectomies, Cesarean sections, coronary artery bypass surgeries, and mastectomies. Conservatives call for tort reform but that wouldn’t address the motive of simple greed in surgeons and hospitals.

While encouraging unnecessary procedures, our profit system denies procedures that are needed. To satisfy stockholders, insurance companies find 1400 ways to “rescind” the policies of people needing care—they simply cancel their policies. Katha Pollitt reports in The Nation that Assurant Health, UnitedHealth and WellPoint saved $300 million between 2003 and 2007 by rescinding at least 19,776 policies. If an insurance company doesn’t dump enough sick people, its stock falls on Wall Street. So says Wendell Potter, who converted from a propagandist for private insurance to testifying in Congress as a whistleblower.

And for-profit companies deny coverage in the beginning. A friend of mine in good health was rejected by three insurance companies. She’s over 60. Was this the reason? What good is health insurance for people who don’t need it?

Then there’s the wasted time and cost of begging insurance companies to pay up. Doctors and nurses spend hours on the phone and in writing trying to get compensation for necessary procedures. While only 3% of Medicare’s premiums go for administrative costs, 10 to 20% of private insurance premiums go for such costs.

In funding efficiency, wait times, rationing, life expectancy, infant mortality, treatment of chronic disease, and use of technology, the World Health Organization ranks our country 37th in the whole world. But we rank first in the amount of money expended. Only in the U. S. can you go bankrupt because you got sick. Over half of our personal bankruptcies result from medical costs.

Loudly-trumpeted are examples of Canadians coming across the border for treatment, but it should be coupled with this fact—the U.S. excels in offering elective surgery for those who can afford it. We lack BASIC, PRIMARY care. We don’t have enough primary-care doctors in the U.S. because specialists earn a lot more. Here we are back to profits again.

This is what our private insurance system has wrought. All systems better than ours have some form of government care. Opponents of proposed reforms like to say we have the best health care in the world. That’s true for the privileged few. Ted Kennedy was one, and the unfairness of that motivated his decades of work to expand care.

One more fact—Minnesota’s health care system really is superb, among the very best in the world. It may be that I’m alive only because of MinnesotaCare—a government system.

What would Jesus say?

Both developed and developing countries around the world grant every human being the moral right to basic health care. Not America, the richest country.

18,000 Americans die yearly because they lack health insurance, reported USA in 2007. A 2009 figure raises that number to 22,000. No other industrialized country lets that happen. Our health care mess accounts for more than half of personal bankruptcies in our country. No other industrialized country lets that happen. Only in America do you go bankrupt because you got sick.

Are Americans crueler than people in other countries?

T.R. Reid, foreign correspondent for the Washington Post and writer about health care, thinks Americans just don’t know how cruel our system is. We in Minnesota don’t know because our system is excellent, among the very best in the world. I may be alive because I live in Minnesota, a state with the "socialist" program of MinnesotaCare.

But thousands elsewhere in our country die for lack of care, when the models of good care exist, some in our own country. What’s the matter?

Certainly Americans in part hesitate to learn from government programs in other countries because opponents of change shout loud lies and use words designed to trigger irrational fears—“socialism,” “euthanasia,” “rationing,” “abortion.” Certainly money from private industries that profit from our dysfunctional system plays a role.

I’m afraid part of our reluctance to learn from other systems is American exceptionalism—the belief that we are best in everything, that we always teach other countries, help other countries, that we have nothing important to learn from them. I’d love to be shown wrong.

Here’s how our profit-driven system rations care:
• It denies insurance to people who obviously need care.
• It cancels the policies of people who, despite a former “clean” bill of health, turn out to need care.
• It wastes hours of caregivers’ time as they beg insurance companies to pay for necessary procedures.
• It focuses on making money. This fundamental law of capitalism works for selling things like cars and mousetraps. But the drive toward CEO and stockholder profits demands culling the expensive unhealthy people.

• It kills 18,000 to 22,000 Americans yearly and accounts for over half of our personal bankruptcies.

I used to think we had to get rid of private health insurance entirely, but T.R. Reid is giving me second thoughts. He points out that some wealthy countries with systems far more effective and efficient than ours have private insurance companies. But they also have strict government regulation.

Kathleen commented,

There is so much misinformation and outright lies being spread about health care. The talk radio "commentators" as well as those with their own TV shows are fomenting such rage in people who think their rights or health care will be impacted. These public figures have a political agenda and get paid millions to promote it. Unfortunately, the health care industry is also spending millions to kill the Obama health plan. Betsy McCaughey of the Hudson Institute, the expert rumor starter, thought up the euthanasia to seniors scenario, which is a total fabrication. But it's working because people believe her after her multi-media blitz! She was also this busy defeating the Clinton health plan.

However, today, I worry about the consequences of the constant barrage of malicious invective by the likes of Limbaugh, Hannity and Beck. Fox News even published the locations of Democratic (not Republican) Town Hall Meetings. They seem to be encouraging these mob scenes. I worry about assassinations. If a tragedy should occur, will these "entertainers" and their sponsors claim responsibility? No.

September 20, 2009Here’s a correction on health care facts just released by Harvard researchers. The number of people who die annually for lack of health insurance is not only around 20,000, it’s 45,000! A co-author and professor of medicine wrote, "We're losing more Americans every day because of inaction ... than drunk driving and homicide combined."
This certainly is a pro-life issue.

"Anonymous" commented:
45,000 is still a small number compared to the million abortions per year which kill unborn persons DELIBERATELY, not simply by inaction. Now THAT is a pro-life issue.
Do you believe in a consistent ethic of life? When was the last time you Pax Christi people protested abortion in front of an abortion clinic?

9 comments:

Anonymous
said...

No other industrialized country lets about 20,000 people die per year because of lack of health insurance.

Well, many of those other countries provide universal coverage. So, of course, people in other countries are not dying from lack of health insurance. Instead, they die from things like government rationing.

Furthermore, always remember that there are only two countries that have more people than the USA: China and India. Since all other countries have a smaller population, there are fewer people they can let die. This makes it easier for those other countries to compete with the USA statistically.

A better statistic is the amount of these deaths PER person. There are about 300 million Americans and if about 20,000 die per year because of lack of health insurance, then the number of deaths is .007% of the population. That's pretty small.

Now, compare this to Canada, which has 33 million people. If the Canadian health care system has the same success rate of .007%, then that would mean 2,200 Canadians die each year because government health care. Let's round that number to 2,000. Since it is easier to manage a smaller number of people, then Canada has an advantage compared to the United States. So we might expect Canada to get that number down to between 1,000 and 2,000. Let's say it's 1,000.

Is the Canadian system costing about 1,000 lives per year? I don't know; I don't have the statistics. But since we have many stories of Canadians fleeing to the United States for health care instead of waiting in line in Canada, I would not be surprised if the correct number is in the thousands.

Anyway, the point is that we should be careful with our statistics. It might sound alarming to hear that the American health care system is costing 20,000 lives per year if we guess that the Canadian system is only costing about 1,000 lives per year. But, actually, this would mean that the US and Canada have about the same batting average.

The style and content of this sound very much like the critic of my theology whose comments I used to publish.

At least this doesn't propagate lies about "death panels," and euthanasia and abortion in a supposed Obama plan. There is none yet.

But the line of rationalizing that brings one to "It's not worse than Canada" will sound convincing to anyone who believed that already. It rests on a premise that's really a hypothetical leap--"they die from things like government rationing."

In any case, Canada presents one of the worst models of government plans. T.R. Reid, in his comparative study of world health care systems says that Canada has the worst wait time. After listening to Reid, I urge Congress to study plans in Japan, Switzerland, and Germany.

Death from government rationing is no more of a hypothetical leap than death from lack of health insurance. In fact, government rationing is worse, because in that case government is more conscious of the fact that it is letting people die, and is more directly responsible for it.

Consider the story of the woman from Oregon with lung cancer under Oregon's state government health program. The program bureaucrats told her that they would not cover her expensive chemotherapy but that they would pay for her euthanization.

It would be naive to think that "death from government rationing" is in no way real and is just hypothetical.

Fact: None of the health reform proposals being considered would stand between individuals and their doctors or prevent any American from choosing the best possible care.Fact: Health care reform will NOT give the government the power to make life or death decisions for anyone regardless of their age. Those decisions will be made by an individual, their doctor and their family.Fact: Health care reform will help ensure doctors are paid fairly so they will continue to treat Medicare patients.

Bottom Line: Health reform isn't about rationing; it's about giving people the peace of mind of knowing that they will be able to keep their doctors and that they will always have a choice of affordable health plans."http://open.salon.com/blog/spittingkitty/2009/08/14/rationed_care_is_the_new_death_panels

We can assume that Congress does not INTEND to reform our system so that it rations care. The question is whether it will lead to government rationing anyway. Many of the currently uninsured will quickly opt for the public plan. As private insurance fails to compete with government, more and more people will be funneled to the government insurance program; and the government can't turn them down from the program if health care is a "right". Inevitably, the program will eat up so much of the budget that the government will have to ration care to save money and to keep the budget deficits under control. It is at that point that the whole program turns into one big rationing (death) panel.

We can already see what is happening with social security and medicare. It is naive to believe that any health reform program will not run into financing problems that are similar or worse.

"Financing problems"Yes, yes, and that is why a public option or one that achieves the same purpose of checking private insurance greed must be in a reform bill. T.R. Reid is persuading me that it can be done while keeping private providers and payers, if we learn from countries that have succeeded in this--Switzerland, Japan, Netherlands, and Germany.

But are the politicians in Washington learning from Germany, Japan, et. al? I doubt it. Thus, it will most likely turn out that any new government program will run into financing problems just as other programs have in the past. That is why the Democrats are ready to bail out on the public option, which is not needed anyway to fix any of the major problems with our health care system. Even the administration no longer thinks of the public option as central to their health reform vision.

So the first thing to do is to block the public option, and then move on to discussing other ideas that will work and be affordable.

No, the first thing to do is to urge Democrats and Republicans to improve the bill.T.R. Reid was asked if there's any hope that politicians in D.C. learn from these governments, and he said he's spoken to them, specifically the Senate Finance Committee, and they understood his message thoroughly.

But the problem is political money given to ugly lies, exaggerations, and distortions. Insurance companies don't want any checks on their profits so, while they're delighted with the prospect of universal coverage (imagine their profits then), they try to block the measures necessary for cost-cutting. Wendell Potter, who used to work for one of the big ones,CIGNA, revealed that to Congress and on Moyers Journal.http://www.pbs.org/moyers/journal/07102009/transcript2.html

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